RESUMEN
Background: The effects of SARS-CoV-2 have varied between significant waves of hospitalization. Research question: Are cardiovascular complications different among the first, delta and omicron waves of hospitalized COVID-19 pneumonia patients? Study design and methods: This was a multi-centre retrospective study of patients hospitalized with SARS-CoV-2 pneumonia: 632 were hospitalized during the first wave (March-July 2020), 1013 during the delta wave (September 2020-March 2021), and 323 during the omicron wave (January 2022-July 2022). Patients were stratified by wave and occurrence of cardiovascular events. Results: Among all hospitalized patients with cardiovascular events, patients in the omicron wave were younger (62.4 ± 14 years) than patients in the first wave (67.4 ± 7.8 years) and the delta wave (66.9 ± 12.6 years) and had a higher proportion of non-Hispanic White people than in the first wave (78.6% vs. 61.7%). For COVID-19 patients who suffered from cardiovascular events, the omicron wave patients had significantly higher neutrophil/lymphocyte ratio, white blood cell and platelet counts when compared to the first wave. Omicron wave patients had significantly lower albumin and B-type natriuretic peptide levels (only 5.8% of the first wave and 14.6% of the delta wave) when compared to either the first wave or delta wave patients. In COVID-19 patients who suffered cardiovascular events during hospitalization, mortality rate in the omicron wave (26.8%) was significantly lower than the first wave (48.3%), time to mortality for non-survivors of COVID-19 patients who suffered cardiovascular events was significantly longer in the omicron wave (median 16 days) than in the first wave (median 10 days). Conclusions: Younger and white patients were affected with cardiovascular complications more often by the omicron variant. Despite higher neutrophil/lymphocyte ratio and WBC counts, the omicron patients with cardiovascular events showed lower heart injuries, lower mortality and longer time to mortality for non-survivors when compared to the first and delta waves.
RESUMEN
BACKGROUND AND PURPOSE: Patients with heart failure (HF) often have increased hostility. The Brief Symptom Inventory (BSI) Hostility subscale has not been evaluated in this population. The purpose of this study was to explore dimensionality, internal consistency, and construct validity of BSI Hostility subscale in HF. METHOD: Measures examined were BSI Hostility, Depression, and Anxiety subscales; Patient Health Questionnaire-9 (PHQ-9); and Multidimensional Scale of Perceived Social Support (MSPSS). Cronbach's alpha, exploratory factor analysis, and correlational analysis were used. RESULTS: Cronbach's alpha for the BSI Hostility subscale was .77. Hostility was positively associated with the PHQ-9, BSI Depression, and Anxiety subscales and negatively related to the MSPSS. DISCUSSION: The BSI Hostility subscale provides a reliable and valid measure of hostility in patients with HF.
Asunto(s)
Insuficiencia Cardíaca/psicología , Hostilidad , Psicometría/normas , Trastornos de Ansiedad/psicología , Estudios Transversales , Trastorno Depresivo/psicología , Femenino , Insuficiencia Cardíaca/enfermería , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios/normasAsunto(s)
Seguridad del Paciente , Cateterismo Urinario/efectos adversos , Infecciones Urinarias/etiología , Infecciones Urinarias/prevención & control , Femenino , Humanos , Unidades de Cuidados Intensivos , Kentucky , Masculino , Estudios de Casos Organizacionales , Resultado del Tratamiento , Estados Unidos , Cateterismo Urinario/enfermería , Infecciones Urinarias/enfermeríaRESUMEN
The purposes of this study were to describe heart failure patient perceptions regarding instructions received for following a low-sodium diet and the benefits, barriers, and ease and frequency of following the diet. A total of 246 patients with heart failure referred from academic medical centers in the United States and Australia participated in the study. A subset of 145 patients provided 24-hour urine samples for sodium excretion assessment. While most (80%) patients reported receiving recommendations to follow a low-sodium diet, their recall of specific instructions was poor. Although the majority (75%) reported following a low-sodium diet most or all of the time, 24-hour urine sodium excretion indicated that only 25% of patients were adherent. Patients who reported being more adherent, however, had lower urine sodium excretion levels. Attitudes regarding difficulty in and perceived benefits of following the diet were not related to sodium excretion. Data on attitudes and barriers provided guidance for strategies to improve adherence.
Asunto(s)
Dieta Hiposódica/psicología , Conocimientos, Actitudes y Práctica en Salud , Insuficiencia Cardíaca/dietoterapia , Insuficiencia Cardíaca/psicología , Cooperación del Paciente/psicología , Educación del Paciente como Asunto , Centros Médicos Académicos , Adaptación Psicológica , Anciano , Australia , Distribución de Chi-Cuadrado , Dieta Hiposódica/efectos adversos , Conducta Alimentaria/psicología , Femenino , Insuficiencia Cardíaca/orina , Humanos , Masculino , Investigación Metodológica en Enfermería , Cooperación del Paciente/estadística & datos numéricos , Sodio/orina , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: Patients with end-stage heart failure experience disability, dyspnea, pain, and suffering at the end of life despite progress in treatment approaches. Little is known about the patients with heart failure in hospice and the impact of hospice care on health-related outcomes. METHODS AND RESULTS: The purposes of this retrospective, descriptive chart review were to (1) describe the characteristics of patients who receive hospice care, (2) identify symptoms most commonly reported by patients with heart failure in hospice during the last 7 days of life, and (3) identify interventions used by hospice nurses to manage the symptoms. The majority of the patients were women, widowed, and white. Median length of stay was 10 days. Nearly 37% of the patients were admitted to hospice during the last week of life. Primary symptoms at admission for hospice care included dyspnea, confusion at least some of the time, and poor appetite. There was no statistically significant difference in symptoms between the day of admission for hospice care and the day of death. Symptom management strategies included oxygen, family reassurance or education, skin care, and patient education. Medications commonly used to relieve symptoms included antianxiety medications, morphine, and/or other narcotics. Although mainstay heart failure drugs had been prescribed for some patients, prescription rates were low and not in line with current guideline recommendations, nor were those medications recorded as being used for symptom management. CONCLUSION: Further research including prospective study is needed to clearly articulate the impact of hospice care on patients and families affected by heart failure.
Asunto(s)
Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/enfermería , Hospitales para Enfermos Terminales/estadística & datos numéricos , Cuidados Paliativos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Cuidadores/clasificación , Cuidadores/estadística & datos numéricos , Comorbilidad , Confusión/epidemiología , Disnea/epidemiología , Incontinencia Fecal/epidemiología , Femenino , Insuficiencia Cardíaca/clasificación , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Cuidados Paliativos/clasificación , Estudios Retrospectivos , Factores Socioeconómicos , Análisis de Supervivencia , Estados Unidos/epidemiología , Incontinencia Urinaria/epidemiologíaRESUMEN
BACKGROUND: Anxiety is common after acute myocardial infarction (AMI) and has the potential to negatively affect physical and psychosocial recovery. There have been no cross-cultural comparisons of anxiety among AMI patients. AIMS: To evaluate whether anxiety after AMI differs across five diverse countries and to determine whether an interaction between country, and sociodemographic and clinical variables contributes to variations in reporting anxiety. METHODS AND RESULTS: A total of 912 individuals with confirmed AMI were enrolled in this prospective, comparative, cross-cultural study. Anxiety was assessed within 72 h of hospital admission using the Brief Symptom Inventory. The mean level of anxiety in the entire sample was 0.62+/-0.76, which is 44% higher than the normal mean level. Anxiety levels were not significantly different among the countries with the exception that patients in England reported lower levels of anxiety than those in the US (P=0.03). However, this difference disappeared after controlling for sociodemographic variables on which the countries differed. CONCLUSION: Patients from each country studied experienced high anxiety after AMI. Even though various cultures were represented in this study, culture itself did not account for variations in anxiety after AMI. It appears that anxiety after AMI is a universal phenomenon.